SACCADES TO SCREEN AND ASSESS COGNITIVE IMPAIRMENT IN OLDER ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract Objective To systematically summarize the evidence of saccade as a screening and assessing for patients with mild cognitive impairment (MCI) and dementia. Methods English databases including PubMed, EMBASE, the Cochrane Library, Web of science, and PsycINFO and Chinese databases including CNKI, Wanfang and VIP were searched. Studies that analyzed the metrics of saccade in people with health cognition, MCI, or dementia were included. The quality of the included studies was evaluated with Cross-sectional/ Prevalence Study Quality from Agency for Healthcare Research and Quality (AHRQ). Study characteristics, participants' characteristics, sample size, saccade procedure, and metrics were extracted from the included studies. Results Twenty-two studies involving 1595 participants were included. Meta-analysis showed that peak velocity (SMD= -0.27°/s, 95% CI (-0.44, -0.11), latency (SMD=-0.36ms , 95%CI (-0.51,-0.20), and accuracy rate (SMD=0.42%, 95%CI (0.17,0.68) of prosaccade between older adults with and without cognitive impairment had significant difference. The performance in latency (SMD=-0.56ms, 95%CI(-0.72,-0.39), accuracy rate (SMD=1.32%, 95%CI(1.07,1.56), and corrected errors (SMD=1.23%, 95%CI(0.98,1.47) of antisaccade in people with health cognition was better than that in older adults with cognitive impairment. The results of subgroup analysis revealed that the accuracy rate of prosaccade, latency and accuracy rate of antisaccade demonstrated crucial difference between health older adults and people with MCI, while only accuracy rate of antisaccade showed significant difference between people with MCI and dementia. Conclusions The metrics of saccade, especially antisaccade, can be a potential screening and assessing tool for MCI and dementia in elderly persons.

and chronological age. We hypothesize that neighborhood social environment and air pollution exposures contribute to racial disparities in DNAm aging. We performed retrospective cross-sectional analyses among non-Hispanic participants (N=2611 White, N=639 Black) in the Health and Retirement Study whose 2016 DNAm age is linked to survey responses and geographic data. We observed Black individuals have significantly accelerated DNAm aging on average compared to White individuals according to GrimAge (599%) and DPoAm (498%). We implemented linear regression models and Kittagawa-Blinder-Oaxaca decomposition to identify exposures that contribute to this disparity. Exposure measures include census-tract-level Social Deprivation Index, perceived social stress, particulate matter (PM2.5), nitrogen dioxide, and ozone. Individual-level determinants include socioeconomic status, healthcare access, health status, and health behaviors. Results suggest these individual-level factors account for ~43% of the disparity in GrimAge and ~34% in DPoAm. Higher neighborhood socioeconomic deprivation for Black participants significantly contributes to the disparity in GrimAge, while greater vulnerability to PM2.5 contributes to the disparity in DPoAm. DNAm aging may play a role in the environment "getting under the skin" and contributing to age-related health disparities between Black and White Americans.

SACCADES TO SCREEN AND ASSESS COGNITIVE IMPAIRMENT IN OLDER ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Qiaoqin Wan, Shifang Zhang, xiuxiu huang, and Xiaoyan Zhao, Peking University, Beijing, Beijing, China (People's Republic) Objective: To systematically summarize the evidence of saccade as a screening and assessing for patients with mild cognitive impairment (MCI) and dementia.
Methods: English databases including PubMed, EMBASE, the Cochrane Library, Web of science, and PsycINFO and Chinese databases including CNKI, Wanfang and VIP were searched. Studies that analyzed the metrics of saccade in people with health cognition, MCI, or dementia were included. The quality of the included studies was evaluated with Cross-sectional/ Prevalence Study Quality from Agency for Healthcare Research and Quality (AHRQ). Study characteristics, participants' characteristics, sample size, saccade procedure, and metrics were extracted from the included studies.
Conclusions: The metrics of saccade, especially antisaccade, can be a potential screening and assessing tool for MCI and dementia in elderly persons. Social media platforms are used by caregivers for persons with Alzheimer's Disease and its Related Dementias (ADRD) to obtain care information. Understanding what types of information caregivers want is critical to developing interventions to provide tailored information. Existing research on caregivers' information wants has relied primarily on manual data analysis, unable to handle the vast amount of data available on social media. In our prior work, we adapted the validated Health Information Wants (HIW) framework to the ADRD caregiving context, forming the HIW-ADRD framework that includes 7 types of information commonly wanted by caregivers. Our longer-term goal is to develop machine algorithms that use the HIW-ADRD framework to automatically classify caregivers' information wants from vast social media posts. Towards this end, we first scrapped posts from ADRD-related subgroups on Reddit, a popular social media platform. We then used few-shot learning, a machine learning method, to extract HIW from the posts. Using questions with question marks as a primary indicator for HIW, we filtered out those sentences and their corresponding background information. Next, we combined the questions and their background information as summaries of the posts. Finally, we sent the summaries to a classification model that classified these summaries based on HIW categories. We used 200 annotated posts to train the model, then tested it on 16779 posts. The evaluation results showed that our model achieved 62.35% in accuracy. These findings provide preliminary evidence for both the deep learning process and the algorithms. This study has implications for future research.

HEALTH SURVEILLANCE OF PERSONS LIVING WITH DEMENTIA AND CAREGIVER DYADS
Annie Robitaille 1 , Neil Drummond 2 , Linda Garcia 1 , Himasara Marasinghe 3 , and David Barber 4 , 1. University of Ottawa,Ottawa,Ontario,Canada,2. University of Alberta,Edmonton,Alberta,Canada,3. University of Calgary,Calgary,Alberta,Canada,4. Queen's University,Kingston,Ontario,Canada The relationship between individuals living with dementia and their caregivers is important and can impact their dementia journey. However, limited national longitudinal data exists about the caregiver-person living with dementia dyad. Availability of such data would provide important information about joint trajectories and help to better identify the needs of caregivers and persons living with dementia across the dementia journey. The objective of this study was to develop a linked national longitudinal database of persons living with dementia and their caregivers. The Canadian Primary Care Sentinel Surveillance Network (CPCSSN) extracts and de-identifies clinical data from electronic medical records (EMR) from approximately 2 million patients across Canada. CPCSSN data is used to identify persons living with dementia and caregivers willing to participate in the study. CPCSSN data from participating dyads are linked (e.g., chronic and mental health conditions, diagnoses, laboratory test results) and additional information about the experiences of persons living with dementia and their caregivers (e.g., ethnicity, amount and type of care provided, burden, availability of support) are collected yearly using surveys. The growing database contains linked, de-identified, comprehensive information about persons living with dementia and their caregivers that will become a rich source of data for researchers, clinicians, and policymakers. Specifics around how the database was developed, and lessons learned will be discussed as these findings can be used as a template to develop similar linked health surveillance databases.

NORMALIZING COGNITIVE EVALUATIONS IN ADULTS: GETTING PEOPLE IN THE SCREENING PIPELINE EARLY Laura Mehegan, and Chuck Raineville, AARP, Washington, District of Columbia, United States
To understand how adults and healthcare providers perceive a dementia diagnosis and cognitive evaluations, AARP fielded a nationally representative survey of adults aged 40 and older (N=3,022) along with a companion survey of healthcare providers in a position to diagnose dementia (N=500). Like healthcare providers, Americans aged 40 and older understand the benefits of diagnosing dementia at an early stage, 81% agree that early detection would motivate them to engage in healthier behaviors to slow the progression of the disease. Adults look to healthcare providers as authorities to determine when a cognitive evaluation should be triggered with 63% saying they would get an evaluation if their doctor recommended it and 49% of healthcare providers saying evaluations should be done if the doctor feels it is necessary and 39% saying it should be done yearly beginning at age 65. The research also showed that most adults (76%) want to know if they have dementia. Additionally, majorities of adults would engage in healthy behaviors if they knew it's good for their brain health. Given the desire to prevent and improve outcomes, routine screening for cognitive function should be as commonplace as getting a screening colonoscopy. Unlike a colonoscopy, routine screening for cognitive function is not a normalized process yet. Data from both populations suggest an opportunity for routine evaluation due to a shared understanding of the long and short-term benefits of screening.